Policlínica Privada de Medicina y Cirugía S.A. v. Municipalidad de la Ciudad de Buenos Aires

P. 169.XXXIII
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Policlínica Privada de Medicina y Cirugía S.A. (Policlínica) brought aguarantee of protection of individual constitutional rights (amparo protection) against the resolution of the Health Secretary of the then Municipality of the City of Buenos Aires.

Policlínica had sought to transfer a minor, who was receiving intensive care treatment in the Petitioner’s premises, to a public hospital. The minor had allegedly exhausted her private insurance benefits, and the private hospital was not willing to continue providing intensive care. However, the public hospital also refused to admit the minor, because the minor and her father were covered by private health insurance.  As an “innovative precautionary measure”, the Municipality issued a resolution blocking the transfer and requiring Policlínica to continue providing care until the civil case determining the extent of the minor and her father’s health care plan was concluded.

Policlínica challenged this resolution. The appeals court found in favor of Petitioner and revoked the resolution, ordering the Health Secretary to allow an immediate transfer to a public hospital.  The Health Secretary appealed the decision and requested extraordinary measures, claiming that the appeals court ruled arbitrarily and the revocation of the resolution constituted a violation of article 2(b) of Law Nº 16.986, which declares any legal protection appeal inadmissible where the challenged act emanates from the Judicial Power. The Health Secretary also claimed that the decision placed the economic interests of Petitioner before the rights of the child.

The Supreme Court dismissed the appeal. It found that the Health Secretary failed to show arbitrariness in the lower court's decision and existence of a federal question that would justify the intervention of the Court in a matter outside its extraordinary competence.

The Supreme Court also found that local authorities could not force private hospitals to keep a patient hospitalized after their term of coverage had ended, and that in such cases, the State had an obligation to provide public health care to the patient after they were no longer able to access private care.  This obligation derived from article 20 of the Constitution of the Autonomous City of Buenos Aires, which created a right to comprehensive health care and an obligation to prioritize health as a social investment, and from article 26 of the Convention on the Rights of the Child, ratified by Law Nº 23.849, which guarantees all children the right to benefit from social security and the adoption of necessary measures to achieve the full realization of that right.  While article 20 of the Buenos Aires Constitution authorized the authorities to seek compensation for services provided to persons with private insurance, it could not be interpreted as a justification for denying public sector health services to such individuals.

The Court therefore held that the authorities had failed to refute the lower courts' decision.

“Que, respecto a los otros cuestionamientos, la demandada no ha mencionado ley o norma concreta alguna que imponga a los servicios de medicina prepaga el mantenimiento de enfermos en terapia intensiva por períodos superiores a los fijados en los contratos de adhesión suscriptos con sus clientes, de manera que no es posible -siquiera con una interpretación amplia del espíritu de la ley 24.754- entender que corresponda denegar la prestación de terapia intensiva en un nosocomio público, tal como dispuso el secretario de salud de la demandada ante el pedido de internación formulado por la amparista.” Paragraph 6. “[…] The defendant has not mentioned a concrete law or norm that requires the prepaid medicine services to maintain patients in intensive care for periods longer than those set forth in the adhesion contracts signed by their clients, and thus it is not possible – particularly with a broad interpretation of the spirit of Law 24.754 – to conclude that the provision of intensive care in a public hospital should be denied, as the Secretary of Health ordered the defendant by means of the admission order made by the petitioner.” Paragraph 6.   “Que el remedio federal no ha refutado el argumento del a quo en el sentido de que la oposición de la demandada al traslado de la niña a un establecimiento público no arancelado, resultaba excesivo con sustento en lo dispuesto por el art. 20 de la Constitución de la Ciudad Autónoma de Buenos Aires que garantiza el derecho a la salud integral y que establece que el gasto público en salud es una inversión social prioritaria.” Paragraph 7. “[...] the defendant’s opposition to the child’s transfer to a no-fee public establishment was excessive, as supported by the provisions of art. 20 of the Constitution of the Autonomous City of Buenos Aires that guarantees the right to comprehensive health and that establishes that public health expenditures are a social investment priority.” Paragraph 7.   “Que, asimismo, la recurrente no ha formulado crítica suficiente a los fundamentos esgrimidos por el a quo para admitir el amparo con sustento en el art. 26 de la Convención sobre los Derechos del Niño -ratificada por la ley 23.849- que impone a los estados partes de ese tratado la obligación de reconocer a todos los niños el derecho a beneficiarse de la seguridad social y de adoptar las medidas necesarias para lograr la plena realización de ese derecho.” Paragraph 8. “[…] the appellant has not presented sufficient criticism of the arguments made by the lower court to admit the amparo petition based on art. 26 of the Convention of the Rights of the Child – ratified by Law 23.849 – which requires the states parties of this treaty to recognize the right to social security benefits of all children and to adopt the necessary measures to achieve full realization of that right.” Paragraph 8.

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